Monday, October 31, 2011

I celebrated in the PICU with the little ones today. And while most people don't like working on holidays, I actually love working this one!

While our census is way high right along with our acuity now, we still have some kiddos that were able to dress up!! I wish I could post pictures, but that would be violating hippa...blah, blah!

But we had quite the assortment: a Sponge Bob, a prisoner (ohh, so sad...a Prisoner of the PICU"), several princesses, and a skeleton.

We also had a few staff members dress up which I fully intended to post pics, but of course the day was CRA-ZAZY!!

In the period of 12 hours I had five different patients. This included being "tripled" (having 3 patients at once) which is just not common in our PICU b/c most of the times the kids are way to sick, admitting one patient from the OR, admitting one pt from the ER, and discharging a little princess home to go trick or treating!

So nevertheless, there was zero opportunity for photo ops- except one that I got passed along.How cute is this t-shirt!!?? Love it!

Had you seen a pic of ME today, you would have seen my ingenious creativity in costume design. I was a full fledge.....

Nurse!

Yes, I know! So creative! But I must say I pulled off the part superbly : )

What did you dress up as?? Or were you working through the holiday as well!?! Either way, I hope that you have a happy, spooky, and fun Halloween!!

Sunday, October 30, 2011

I love my job. I say it all the time. When parents of patients ask why I drove almost 3 hours each day to get to and from work, I tell them it's because I truly love what I do!

And I feel so lucky for being able to say that. Because really, how many people out there look forward to going into work each day!?

Don't get me wrong...there are many days that the alarm just seems to go off way too early.

Or days that I walk into a room that looks like it should belong into a circus with all the pumps and machines which makes me nervous! But a good dose of healthy fear of what we do gets us through our job. When a PICU nurse becomes too "comfortable" it can be a scary time!

But back to my love of my job. I seriously love working with kids. I love making a difference in their life. Impacting not just the health of a child, but the overall well-being of an entire family.

And I especially love that once I clock out, I can leave the job behind. I don't have any paper work or responsibilities once I'm home.

Which really leaves me time to do other things that I love. Once of these things is trying to come up with healthy recipes for Jon and I to enjoy. And let me tell you, I found another one that will become a staple for us this fall and winter so I thought I'd share it...we've already made this twice in 2 weeks! That's substantial for us!

Plus, it makes enough leftovers so I can take it to work the next day and have tons of nurses stare longingly at my lunch! No lean-cuisine here...just some delicious, healthy soup!!!

*Note: I don't measure things most times, so you'll just have to bear with my recipe! But, I adapted this from a few different mexican meatball soups that I found online so you could find exact measurements if you want.

Crock-pot Mexican Meatball Soup

-In a crock pot, mix chicken stock or broth to fill about 3/4 of the way. Add in one can of black beans, frozen corn to your liking, one can of Rotel or another "mexican" flavored spicy tomatoes, a few splashes of lime juice, a few diced up jalapenos, a dash of salt and a dash of pepper. Cook for 2 hours on low.

-To make the meatballs, take ground turkey or ground beef (we used lean ground turkey to be a bit healthier) and add fresh cilantro, salt, pepper, and hot pepper flakes. Form into 1-2 in balls. Place in broiler for about 4-6 minutes (or until outside starts to brown). Once browned, place in crockpot with the rest of the soup and turn to high for about an hour.

-Once the soup is done, make a plate of "fixins" to put on top. We used tortilla chips, avacado, sharp cheddar cheese and fresh cilatro. -Serve with a glass of spicy red wine and enjoy....YUM!!!

The only unfortunate thing about the leftovers at work is the glass of red wine is not included. But it still tastes awesome!

Thursday, October 27, 2011

I don't often solicit unwanted advice. And I certainly don't solicit medical advice to adults.

For one, I don't work with adults. For two, I'm not licensed or credentialed to do so. And three, I just like kids better.

But this week I most certainly gave advice to an adult and felt no remorse about it!

The aunt of a patient came to visit around 1:30 pm. She came into the room next to me where I had been helping out most of the day. My patient wasn't very sick. This patient was.

The aunt looked a bit overwhelmed when she walked into the room, and I don't blame her. The patient is extremely sick with cancer, and is hooked up to a bunch of machines. The room just looks overwhelming from the outside.

About 3 minutes into the aunts visit, she started to look really flushed, and then pale. As she started to fan herself and say "It's so warm in here...."

I'm sure you can guess where this is going. Down she goes!!!

And let me tell ya. This lady passed out hard and fast!! She conked her head on the wood floor HARD! I was standing about 10 feet away and heard her head hit! Ouch!

I always say "go big or go home" but this is taking it to the extreme. OK, I guess I've never really said that, but it is a saying. So someone must've said it before. And I bet they were really smart!

But back to the Fainting Fun. So of course the aunt is unconscious, and another nurse pulls the code button. We need some help in here.

And in a not funny situation, we managed to laugh (after the fact of course!). As the nurse pushes the code button, all she kept saying was "We have to make sure everyone knows the code isn't for the patient...We have to make sure everyone knows who the code button is for!"

Now let me just tell you, there is a grown woman sprawled out, unconscious on the floor blocking the doorway. I'm pretty sure staff members running in the room will see pretty clearly that the patient is fine. But the lady on the floor, not so much!

Luckily, she woke up shortly after she fell, and was more embarrased than hurt.

Despite insisting that she was fine, we still hooked her up to a transport monitor to make sure her vitals were stable, and I grabbed a quick accucheck to see what her glucose was.

Only her glucose was SO low, it wouldn't even register on our machine.

Which was when the aunt said that she hadn't eaten since 3pm the day before. And she played competitive volleyball the night before. Oh, and one more little detail- she also went for a 6 mile run that morning!

So this was where my unsolicited advice came in. And I felt pretty confident that despite not having adult experience, this was warranted!

For the love, before coming into the PICU, please eat!

And if you are choosing to do the "no food and tons of exercise diet" please stay away from our PICU.

Because us PICU nurses like saving lives...but only the little kid-like ones : )

Wednesday, October 26, 2011

Do you ever have times when you are so super busy and all you can think about is the time in the future when you will actually have some free time!? And then that time actually comes, and you wonder where in the world all that "free time" actually is!?

Yeah, that's happened to me!!

I must say that while school is done, I have wasted NO time in filling up my schedule with "stuff." And while the past 2 weeks of being "done" have been awesome, they certainly have kept me busy.

I'll take busy working out, busy catching up with friends, busy with lunch dates, and busy with hubby time over school busy any day though! So there are NO complaints here!!

And the PICU has manned up to its reputation and kept me busy over the last week!

One minute our census is low, we're "floating" to work on other floors, and the kids we do have in the PICU just don't really seem to need to be there!

If ever there was a perfect recipe for causing PICU nurses to complain, this is it!! We don't like to "float" to other units. The NICU is typically the place we go to most often, and while we share 3 letters (why do I have the strong urge to spell these 3 letters out to you...literally!?), we are WORLDS apart. And we like it that way!!

Sometimes, we have to go to the "floor" (AKA: not an ICU), and this is definitely a different world!!! When kids aren't in the PICU, they don't need things like breathing tubes or the really good pain meds...all of which keep them quiet! So the floors have lots of complaining kids, whining kids, bratty kids!!

HA- I just read that, and completely realize what it makes me sound like. But, it's the truth. And yes, I still LOVE children...even the talking, crying, sometimes screaming ones!

But lucky for me, it was not my turn to float this past week. I got the joy of watching the PICU go from 21 patients to 40 in what seemed like a matter of one night.

And the kids we're getting are SICK! Like, yes, you deserve this PICU admission sick!

All of this busy-ness caused me to have 3 assignments on one day, which is loads of fun! Makes floating to the NICU where you have 2 or 3 "feeder-grower" babies not so bad!

But I have to say, now that I'm done with school, I LOVE being busy in the PICU. Before, I wanted the "nice" assignments so that in my down time, I could get school work done. But now that there's no school work, I'm loving the busyness again!

Ahh, feels just like I'm a new grad again craving the hard assignments. The sick assignments. The ones where I don't sit down all day. Or drink water. Or pee. Yeah, this sounds really healthy! But it certainly makes the day go by so much faster!

And maybe tomorrow I'll even make time to tell ya about some of the busyness. Because there were some great PICU nuggets in there!

But now I'm off, to actually enjoy a non-busy night. Since Jonny isn't feeling well, we have grand plans for comfy pants, some wine and cheese, and catching up on our DVR. That sounds like a perfect, opposite of busy, evening to me!

Wednesday, October 19, 2011

So is the saying "Looky, looky" creepy?!? I wasn't sure, so I just went with it!

But seriously, look what happens when you graduate from a masters program...

The wonderful husband gets you THIS:He will also get you THIS....

but we're not going to talk about that!!!

OK, in all fairness, he got himself that. It just so happened to come at the same time...in the same box. At least that's his story!

But back to Mr. Vienna plus! Oh he is a marvelous contraption (apparently I've wondered back into the 1800's this morning). This bad boy really is awesome though. He allows me to WANT to wake up early! Just so I can go downstairs and do this....

Mmm, pumpkin spice latte (made by moi!) with my pumpkin spice candle and a good book. Now that's a great morning. And all while the man is still snoozing away upstairs! Yup, I am definitely a morning person. He is not.

And just thinking about all the money we'll save on latte runs b/c I can make my very OWN starbucks now is OH. SO. EXCITING!

It has also contributed to a problem I like to call "Shake That"...and yes, you have to sing the song while you're doing it! I have GOT to figure out how to tone down the amount of caffeine that goes into my daily latte b/c WHOA MAMA, I look like "New Nurse Nervous Nelly"!!!

It's gotta make parents feel right at home when my hands are trembling while trying to flush their IV. And my "Oh don't worry, I've been doing this for 6 years" doesn't really go very far apparently!

So if you have any tips on how to make a less caffeinated version of my fav fall drinks, please leave a comment....hint, hint my barista friends!

Oh, and in case you were wondering...the instruction manual for Mr. Vienna was fabulous. Not only did it NOT really explain how to use it, or how to appropriately caffeinate the drinks, it also gave you very helpful pictures such as this:Not only should you not wipe it down with a cloth (what ARE you supposed to wipe it down with!?) you should also not let your baby who looks like they're up to no good crawl all over it! And put his bum right on on the steaming knob!

Although if you did, it would give this PICU nurse one good admission story to blog about! So do what you choose : )

Whoa baby! Not even sure what to do about that now! I think I'll just enjoy it for today and let the "thinking" start later.

My brain hurts because boards were NO joke!

The whole testing procedure was no joke! You walk into the room and have to surrender all personal belongings to a locker. Well, all personal belongings except for 2 forms of identification. Because clearly, a state issued ID with my picture and signature on it would not suffice!

Once everything was in the locker, it was made very clear that you could not take ANYTHING into the testing room at all! And just to ensure that there were no gummy worms, video games, or other such propaganda entering into the sacred testing zone, they had a wand-y thing like at the airport. And a pat down.

Yes, you heard me. There was a pat down.

I had to stand on a duct tape X on the floor when the testing lady asked me to "pat my pockets down" to ensure that there was nothing in them. I looked down at my outfit (boots, leggings, and a long button down shirt...all without pockets). After telling her I didn't have any, she finds these 2 pseudo pockets on my shirt.

Right on my....

YUP, right there!! AND she asked me to pat them!

At first I thought she was joking. But when I looked up she was as stern and serious as you can imagine!

So right there, standing on that little silver X, in front of others waiting for their personal pat down, I gave my ta-ta's a nice little pat down. 4 pats to be exact. Because apparently that's how many I thought would appropriately show that the only thing under those pockets were my lady lumps.

Wish I could say I enjoyed it.

What I can say is the guy next to me in line seemed to greatly enjoy it. In fact, his facial expression said "Dude, I SO need to take these tests more often!"

I, on the other hand, will not be taking these tests more often. Or ever again for that matter!

Because I'm done! Because I passed boards!! And because I can pat my lady lumps down in the comfort of my own home without an airport wand-y thing. Or a stern lady staring at me. Or a "boy-man" who is all too excited about it.

OK, so most likely the last part will be included in my home. But at least I will know the guy. And hey, ya can't fault him!

So these lady lumps and I (ahem, the new RN, MSN, AC-PNP) will be out celebrating tonight! But not too late, because the PICU calls early in the morning! Oh the adventurous life I lead! : )

Friday, October 7, 2011

Yesterday work was quite the doozy!!! I think anytime the PICU knows that you're going to have a vacation, or a 3 day weekend, it wants to make sure you deserve it!

So I said, "Bring it PICU!"...and it did!!!

My morning started off caring for "my boy" who I've mentioned here and here- (poor guy has posts written back to the beginning of my blog!). Anyways, he decided he didn't want to wake up...or be arousable at all first thing in the morning. Nothing like a bit of a pick-me-up before all the coffee has been consumed all too early in the morning!

Once that was settled, my other patient was being discharged home. Not too shabby....until I learned they only speak Arabic. Not a WORD of English! Great!!

OK, actually them not speaking a WORD of English was a lie. For some reason they knew the words "donut" and "coffee!" So random! In my book, if you're going to know one word of English, coffee should definitely be it!

Donut? Maybe not! But, they kept offering me donuts, and I just kept trying to say "No thank you." Then after more probing (and practically pushing a french crueller in my face!) I put my hands on my stomach and then hips and wiggled a bit, trying to indicate, "nope, don't want the donut...trying to NOT gain 6 pounds this morning!!"

The dad laughed (in his hearty Arabic laugh of course!). So he either got my game of charades, or he thinks that I was doing some weird American "no thanks donut dance"! Either way, the crueller backed out of my face thank-goodness...that sweet gooey-ness almost didn't stand a chance!

I found myself trying to play charades with them all day, and even threw in a few words of Spanish in with my English. As if that would help us suddenly understand one another!

Once I got that girl outta there, I got a new one just as quickly!

She was a cutie. Her mom was not!

I have to constantly remind myself that these parents act crazy because their child is coming into the hospital really sick. That if I happened to pass them on the streets, they wouldn't grab my arm, or yell at me, or try to tell me I'm not doing my job.

They probably wouldn't do that!

But this mom was doing it all. I just stayed as patient as I could, and continued to care for the cutest little girl having a NASTY asthma attack.

My saving grace was this mom was Asian and had the thickest accent. So all her yelling was kinda funny. The way she said things anyways! And I figure, the things I didn't fully understand was probably a good thing!

What I want to tell parents sometimes is their crazy, frantic, arms waving in the air, yelling behavior is only taking me away from caring for their child. And in the grand scheme of PICU things, their child was not THAT sick! But they don't know this. So I just keep being patient.

Sometimes patience is the only thing that will get me through the shift. That and focus. I just focused (patiently) on my patient. The child one. Because sometimes the parent ones can just as easily become a second patient.

But now it's FRIDAY!!! And I don't have to work!! And I don't have to work for 3 whole days acutally!!! YEAH!!! So I am putting the PICU behind me (for now!).

What do I get to do?? Spend the next 3 days with the hubs! Spending some definite cuddle time with my man while we sleep in or stay in bed extra late catching up on our shows. And of course there will also be some soccer playing, some pumpkin patch'ing, some spending time with great friends and their cutest little twins (!!!), some football watching, and some great food! Now how's that for a great weekend!

But now I must go, b/c the best husband in the world just brought me breakfast! Mmm!!

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About Me

I am a new PICU Nurse Practitioner working in the same PICU where I had previously been a bedside nurse for 7 years. This blog is a way for me to document the many fun, memorable, crazy things that come out of taking care of PICU patients. And occasionally I like to throw in some personal documentation of other things that I love- cooking meals with my man, drinking a great glass of wine, decorating my home, thrift shopping, high heel wearing, and traveling. This is my adventure...thank you for stopping in to enjoy the ride!
DISCLAIMER: Any stories in this blog are written to protect patient confidentiality and not violate HIPPA. Names, ages etc. have been changed. If you think that I'm talking about you, I'm not...there are tons of other patients out there that have the exact diagnosis as you, and the same loving/crazy/wonderful/stressed out/amazing/wacko parents to back them up! : )